培美曲赛维持治疗非小细胞肺癌临床疗效观察

Efficacy in the Mintenance Treatment of Non Small Cell Lung Cancer

目的：观察培美曲赛维持治疗非小细胞肺癌的疗效及预后。方法：连续观察我院2012年6月至2014年6月住院维持治疗的非小细胞肺癌患者98例,53例采用培美曲赛单药维持治疗患者,24例采用多西他赛单药维持治疗,21例采用吉西他滨单药维持治疗,每2个周期评价客观疗效,达到ORR的患者继续维持治疗,其它患者换药治疗,同时记录维持治疗期间的不良反应。结果：2个周期维持治疗后培美曲赛组、多西他赛组、吉西他滨组ORR率分别为24.53%、8.33%、0.0%（P〈0.05）。培美曲赛组平均无进展生存期为（8.7±1.3）月,明显长于多西他赛组和吉西他滨组（P〈0.05）。三组平均生存期比较差异无显著性（P〉0.05）。培美曲赛组主要的不良反应是骨髓抑制,Ⅰ-Ⅱ级、Ⅲ-Ⅳ的发生率分别50.94%和11.32%,略低于多西他赛组和吉西他滨组,但差异无显著性（P〉0.05）,恶心呕吐发生率低于多西他赛组和吉西他滨组（P〈0.05）。三组在其它不良反应比较差异无显著性（P〉0.05）。结论：培美曲赛维持治疗非小细胞肺癌,患者耐受性好,不良反应较轻,完成治疗比例高,无进展生存期长,是提高预后的较理想药物。

Objective： To observe the efficacy and prognosis in the maintenance treatment of non small cell lung cancer with pemetrexed. Method： 98 cases in our hospital from June 2012 to June 2014 were selected as the objects for maintenance treatment of non small cell lung cancer,53 cases were treated with pemetrexed single drug maintenance,24 cases with docetaxel and 21 cases with gemcitabine,with every 2 cycles of objective evaluation of curative effects,the patients up to ORR continued to receive treatment,and other patients changed the drug. The adverse reactions were recorded during treatment. Result： After 2 cycles of LORR rates in maintenance therapy pemetrexed group docetaxel group and gemcitabine group,were 24. 53%,8. 33%,0. 0% respectively（ P〈0. 05）. The average progression-free survival period was（ 8. 7 ＋ 1. 3）months in pemetrexed group,significantly longer than the other two groups（ P〈0. 05）. There was no significant difference about average survival period of the three groups（ P〈0. 05）. The main adverse reaction was bone marrow suppression,and grade I - II,Ⅲ - Ⅳ incidence were respectively 50. 94% and 11. 32%,slightly lower than those in the docetaxel and gemcitabine group（ P〈0. 05）. The incidence of nausea and vomiting was also less than the other two groups（ P〈0. 05）. Comparing the difference in other adverse reactions of the three groups was not significant（ P〈0. 05）. Conclusion： The application of pemetrexed in maintenance treatment of non small cell lung cancer was helpful,patients could keep good toleration,show mild adverse reactions,with a high proportion of treatment completion and a long,progression free survival period. It is an ideal drug to improve the prognosis of the patients.